Emergency Medical Services Board Meeting
March 7, 2001

Members present:                             
Marv Birnbaum             
Cheryl Glomp                                                                           
Dan Williams                           
Gloria Murawsky                                          
Dick Collyard                                                
Mark DeGuire                    
Gloria Wall
Tim Bjelland
Steve Teale

Bureau Staff:
Nan Turner
Rick Barney
Jon Morgan

Others in Attendance:                         Representing:
Patricia Padjem                                               UW EMS Program
Mary Austin                                                    Monroe Clinic
Debra Sweeney                                            Monroe Clinic
Sharon Thorpe                                                Wausau Hospital
Sam Palzkill                                                   Curtis Ambulance
Ronald Meyer                                                Oconomowoc Hospital
Lorie Utech                                                    Pro-Health Care Inc
Larry Knuth                                                     Paratech Ambulance
Kim Pemble                                                   Infinity Healthcare
Chris Felton                                                   Infinity Healthcare
Robin Blankinship                                        Gateway Tech
Jim Keiken                                                     Madison FD
Kenny Asselin                                               West Bend Firefighter
Jeff Petermann                                         West Bend Firefighter
Judy Jones                                                     Luther – Eau Claire
Keith Kesler                                                   Douglas Co. Emergency Mgt.
Kathy Crandall                                              EMS Coordinators
Dave Henning                                              Gold Cross Ambulance
Don Kimlicka                                                 Gunderson Lutheran – LaCrosse
Mark Madigan                                             County Rescue
Robin Schultz                                     Sacred Heart Hospital – Eau Claire
Jon Schultz                                                     Eau Claire FD
Scott Schneider                                          Two Rivers FD
Carol Immermann                                        Franciscan- Skemp – La Crosse
Len Orlando                                                   Green Bay Fire Dept / PFFW
Pat Kilbane                                                    PFFW/Janesville FD
Paulette Hesch                                     Franciscan Skemp

 

Agenda item #1 Introductions

Dan Williams called the meeting to order at 10:00 at the Crowne Plaza, Madison.  Everyone in attendance introduced himself or herself.

  Agenda item #2 Approval of January Minutes

Motion by Gloria Murawsky, Second by Dick Collyard to accept the January, 2001 Board minutes.  Unanimous approval.

  Agenda item #3 Presentation on EMSystem database

Chris Felton, Kim Pemble and Bill Bazan presented a computer database that provides real time information about hospital emergency department status: open or closed and need for diversion.  The system allows providers to manage patients because of upfront information about current resources at hospitals.  Other potential uses include: early identification of bioterrorism illness, AHA stroke study, EMS run reporting, trauma care, public health, and others??.

  Agenda item #4 Committee Updates

·        Policy & Practice

Dick Collyard reported on the committee meeting.  HFS 110 is now in place, but two items were accidentally left out of the rule: EMT-basic IV training permit language and preceptor qualifications.  The committee recommended elimination of the need for training permits at all levels.  Motion by Dick Collyard to eliminate training permits at all levels, second by Cheryl Glomp.  All present - Aye.  This will require a change in statutory language.

Most of the committee work is being done with HFS 111.   The document has been reviewed and forwarded to the EMS Section with recommendations for changes.

  HFS 112 is being discussed at the legislature.  

The interfacility document will be ready for review by the committee at the May meeting.

     Data and Research

Mark DeGuire reported on the committee meeting.  The committee reviewed the new state electronic operational plan template and discussed how it can be utilized in the CQI process.

  The committee has begun work to create a chart of CQI elements.  There was a discussion of what should be the process for CQI in education, provision of care, etc. and how do you build CQI at the service levels.  Motion by Mark DeGuire to mandate that any new ambulance service or any ambulance services moving to a new license level have a CQI plan, second by Marv Birnbaum.  All present - Aye.  Motion by Mark DeGuire to require services to have a mechanism in place to collect data within 2 years after a state established start date, second by Marv Birnbaum.  All Present - Aye.  Motion by Mark DeGuire to recommend to the bureau that the vacant data position in the bureau include the following 3 components in the position description: 1) education and knowledge of CQI; 2) technical support and data submission; and 3) data analysis and reporting, second by Marv Birnbaum.  All present - Aye.

  Mark DeGuire and Nan Turner will work together to get some current basic useable data to report back.  The discussion on the use of data for evaluating the new EMT Basic IV level (education vs. care issues) was placed on hold.

     Systems Management

Marv Birnbaum reported on the continued work of the Systems Committee. Major projects:

1)                 Dispatcher surveys were sent to sheriffs and emergency management directors.  Responses were still coming in, but it was clear there are a lot of unknowns and that not all people understand medical dispatch.  The committee discussed interest shown by the press and a legislator about requiring medical dispatch training and the difference between dispatchers & communicators.  The committee will meet on April 5th at 4:00 following the administrator's track at the Paramedic Seminar in Oshkosh.  The committee feels they have made contact with key stakeholders and will report to the Board in May and to the NHTSA review in April.

  2)                 Finance piece – the result of 27 structured interviews is complete and the data collection is complete.  The goals & objectives will be include in the finance report with the first draft to be presented in May.

   Education

Gloria Murawsky reported that the committee reviewed the status of training at all license levels and also reviewed the new EMT-Intermediate curriculum.  There was also discussion of the need for a critical thinking module at the EMT-basic level.  It was thought that this could be evaluated at the EMT-basic IV level first.  It was also reported that there are 2 committee members whose terms have expired.

    EMS-Children

An update was given on the PEPP (Pediatric Education for Prehospital Professionals) courses being sponsored in the state.  The 2nd Annual EMSC & Injury conference is scheduled for October in Wisconsin Dells.  A course to train schoolteachers in BLS is being planned for this summer.  The goal is to get them to include this training in the school curriculum.

Agenda item #5 Medical Director Report

Dr. Rick Barney talked about the rollout of the IV Tech and the development of a sample set of protocols that can be used as minimum guidelines.  He also discussed the difficulties with completing the EMT-Intermediate curriculum because it's based on the paramedic curriculum.  There has been a line by line assessment of the curriculum which was reviewed by the Physician Advisory Committee (PAC).  The final steps are review of the new National Registry EMT-I exam and the rollout in the fall.

  Dr. Barney also reported on EPAC activities including:

·        The MD course which is complete except for one chapter.   It will be reviewed at the next PAC meeting, will be web based and the target date for release is Dec. 31, 2001 with a recommendation to have all EMT-I and EMT-P medical directors take the course.

·        PEPP course is being suggested as a replacement for current pediatric curriculum.  NO decision has been made & Dr. Perloff is doing a line by line comparison.

·        A demonstration was given of CPAP at the last meeting and PAC recommended its use be approved for EMT-P and EMT-I services.

·        Preparing for NHTSA reassessment April 23-26.  Most of the areas that are incomplete from the last assessment are related to lack of funding or legislation.

·        Trauma Plan.  A presentation is planned for March 20 to the Senate Human Services Committee.

  Agenda item #5 Legislative & State Office Update

Nan Turner reported on the following items:

·        NHTSA reassessment site visit is scheduled for April 23-26.  There was a discussion about presenters and how they would be determined.

·        HFS 110/112 - The EMT-basic rule (HFS 110) became effective March 1, 2001.  The EMT-paramedic rule (HFS 112) is at the legislature.  A hearing is scheduled for March 28.

  Agenda Item # 6 - STAC and Trauma Plan update

STAC Update – The Statewide Trauma Care System Plan has been completed and is at Joint Finance.   Nan Turner & Jon Morgan gave a presentation as an overview of the trauma plan proposal.

Agenda Item #7 - Board & PAC members with terms about to expire

Dan Williams discussed committee members with expiring terms.  Committee appointments will be considered in May after the Board has a better idea of its short and long term focus.  The Board's plan is to:

·        Reevaluate issues not completed and prepare for NHTSA

·        Reevaluate the current task list

·        Put a hold on any new initiatives

·        Review the current State EMS Plan for each focus area

·        Consider using April to complete any pending work

The Board will look at holding a retreat in June to identify priorities.  It is likely that some of the NHTSA recommendations will be the focus of activities in the upcoming year.

  The PAC also has 3 members with terms that expire in July.  Interested individuals should send Nan Turner a short letter of interest and a CV

Agenda Item #8 - - Old/New Business

There was a discussion of the problems that arise when hospitals divert patients.  The EMS Board stated this was outside their role, but requested that DHFS look into it.  Motion by Marv Birnbaum to recommend DHFS convene a statewide task force to review problems with diversions and emergency department overcrowding, second by Mark DeGuire.  All Present - Aye.

  The Board would like to send a formal congratulatory note to John Chapin, Division of Public Health Administrator, who recently won the President's Award from the State Medical Society.

  Board email group will be shared with Bill Bazan to provide trauma plan information with interested parties.

  Motion by Mark DeGuire to adjourn, second by Gloria Murawsky. All present- Aye. Meeting adjourned at 12:30 PM.

  The next meeting will be held on May 1 & 2 at the Holiday Inn in Mosinee,